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目的探讨哈萨克族心力衰竭(HF)患者血浆和肽素(Copeptin)水平变化以及在临床中的意义。方法选取2009年12月～2010年4月收治的哈族HF患者90例(NYHAⅡ～Ⅳ级),选取同期住院无心功能不全患者30例(NYHAⅠ级),采空腹静脉血,测定血浆Copeptin、总胆固醇(TC)、三酰甘油(TG)、血糖(FPG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、载脂蛋白A1(Apo-A1)和载脂蛋白B(Apo-B),计算体质指数(BMI),超声心动图测量左房内径(LAD)、左室舒张末内径(LVEDD)、左室射血分数(LVEF)、左室短轴缩短率(FS)等指标。结果哈族HF患者血浆Copeptin显著高于对照组,并随NYHA心功能分级的升高而升高,各组间差异均有统计学意义(P<0.01)。相关分析显示,血浆Copeption与心功能分级、LAD、LVEDD呈正相关(P<0.01),与LVEF、FS呈负相关(P<0.01)。结论哈族HF患者血浆Copeptin水平显著升高并与HF病情程度有良好的相关性,与左心扩大程度呈正相关。Copeptin可以作为判断哈族HF患者心功能的一个良好指标。
Objective To investigate the plasma level of Copeptin in Kazakh patients with heart failure (HF) and its clinical significance. Methods Ninety HF patients (NYHA class Ⅱ ~ Ⅳ) were enrolled from December 2009 to April 2010 in our hospital. Thirty patients (NYHA class Ⅰ) without congestive heart failure, TC, TG, FPG, HDL-C, LDL-C, Apo-A1 and apolipoprotein (Apo-B), body mass index (BMI), left atrium diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left ventricular fractional shortening FS) and other indicators. Results The Copeptin level in HF patients with HF was significantly higher than that in the control group and increased with the NYHA functional class. There was significant difference between the two groups (P <0.01). Correlation analysis showed that plasma Copeption was positively correlated with cardiac function classification, LAD and LVEDD (P <0.01), and negatively correlated with LVEF and FS (P <0.01). Conclusions The level of Copeptin in Kazakh patients with HF is significantly increased and has a good correlation with the severity of HF and positively correlates with the extent of left ventricular enlargement. Copeptin can be used as a good indicator of cardiac function in Kazakh HF patients.